Alltop RSS Alltop RSS feed for en-us Fri, 24 Nov 2017 08:24:52 -0800 This RSS feed URL is deprecated Fri, 24 Nov 2017 05:00:00 -0800 Five common causes of early morning headache Fri, 24 Nov 2017 04:03:53 -0800 Dear Abby: Landlord questions tenant's claim that he sleepwalks - Bloomington Pantagraph (blog)
Dear Abby: Landlord questions tenant's claim that he sleepwalks
Bloomington Pantagraph (blog)
Dear Abby: I am a man who owns a large four-bedroom home, and I have two tenants. One pays the rent on time, helps with cleaning and yard work, and is an all-around great roommate. The other has been here for four months, has never paid his rent on ...

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]]> Fri, 24 Nov 2017 02:53:11 -0800 UW study searches for signs of unsettling sleep -

UW study searches for signs of unsettling sleep
Poorang Nori, a research tech at Wisconsin Sleep, injects conductive gel into electrodes embedded in a net covering Steven Bochte's head before Bochte undergoes a sleep evaluation. Boche, of Madison, has REM behavior disorder, in which people act out ...

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]]> Fri, 24 Nov 2017 01:09:02 -0800 The ability to self-monitor cognitive performance during 60  h total sleep deprivation and following 2 nights recovery sleep - Boardman JM, Bei B, Mellor A, Anderson C, Sletten TL, Drummond SPA.

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]]> Thu, 23 Nov 2017 14:00:08 -0800 Stranger Things cast answers the most googled questions about the show

Gaten Matarazzo and Joe Keery, a.k.a.  Dustin and Steve, developed an adorable friendship during the second season of Stranger Things, and it seems like that friendship has carried over from the fictional world into the real world. Here they are with Wired to answer some of the web's most googled questions about the show. It's actually pretty interesting to see the questions people ask about the show. For example, some people seem to think that the show was based on a true story. Go figure...

The post Stranger Things cast answers the most googled questions about the show appeared first on Holy Kaw!.

]]> Thu, 23 Nov 2017 12:00:06 -0800 Why did it take China so long to figure out how to make ballpoint pens?

Ballpoint pens are so ubiquitous that it seems impossible that China doesn't make them. But, as a matter of fact, China has never been able to make a good ballpoint pen because the engineering is too complicated. That's because the ball in the ballpoint pen needs to be housed very specifically and with very specific metal. If the metal is even a little bit lower quality than it needs to be, then the pen won't work right––ink will spill out too fast or not enough, or the ball will lock up. 

The post Why did it take China so long to figure out how to make ballpoint pens? appeared first on Holy Kaw!.

]]> Thu, 23 Nov 2017 10:00:05 -0800 The tragedy of the commons, explains

Imagine a pond full of fish. There's a group of fisherman who all live around the pond and rely on the fish to survive. You'd think that the fisherman would all work together to make sure they don't overfish the pond. But that doesn't happen––each person eats more fish than they should and, as a result, the pond runs out of the fish and they all go hungry. This is called the tragedy of the commons. People work against the interest of society in order to further their own interests, which actually screws them over in the long run. 

The post The tragedy of the commons, explains appeared first on Holy Kaw!.

]]> Thu, 23 Nov 2017 08:00:03 -0800 Do achy joints really predict bad weather?

We all have a grandma or grandpa who claims to know when it's about to rain because their joints ache. They may even claim to have an accuracy percentage higher than the local weather man. But is true that aches and pains predict bad weather? This video lays out a series of scientific studies that say, basically, there's no conclusive evidence that joints predict bad weather. That doesn't mean you can disrespect grandma, though. It's probably in your best interest just to bring an umbrella. 

The post Do achy joints really predict bad weather? appeared first on Holy Kaw!.

]]> Thu, 23 Nov 2017 06:44:00 -0800 Burnout has ‘adverse effects’ on job performance of nurses Thu, 23 Nov 2017 06:00:01 -0800 Binging with Babish makes Rachel’s Trifle from Friends

Most "Friends" fans probably remember Rachel's famous "English Trifle," a dish so bad that it allegedly tasted like feet. See, what happened was Rachel combined two recipes: an actual trifle and shepherd's pie. The result? A disgusting mix of savory and sweet. Babish makes the recipe according to spec in the first part of this video, but it's so bad that he actually can't get it down. So instead, he tries to make something more palatable using corn bread, a more savory jam, and some delicious meats. If you try it, let us know how it goes in the comments. 

The post Binging with Babish makes Rachel’s Trifle from Friends appeared first on Holy Kaw!.

]]> Thu, 23 Nov 2017 05:35:31 -0800 Can symptom tracking apps help people manage their arthritis? Wed, 22 Nov 2017 15:20:00 -0800 Simple steps can mean more sleep, better health - FOX 13 News, Tampa Bay
FOX 13 News, Tampa Bay

Simple steps can mean more sleep, better health
FOX 13 News, Tampa Bay
TAMPA (FOX 13) - Everyone has their own way to get to sleep. Some watch TV and fluff the pillows or listen to white noise. As well as making us drowsy, losing sleep impacts us medically. Lack of quality sleep disrupts the circadian rhythm, an internal ...

]]> Wed, 22 Nov 2017 14:15:58 -0800 Sleep is essential to staying healthy - Pocono Record - Pocono Record
Pocono Record

Sleep is essential to staying healthy - Pocono Record
Pocono Record
Sufficient and good quality sleep helps recharge your health and your brain. It helps you to enjoy your life while making better decisions and staying safe,” says ...

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]]> Wed, 22 Nov 2017 10:00:14 -0800 Light Pollution Is Getting Worse Every Year. That ’s Bad For Your Health Wed, 22 Nov 2017 07:42:14 -0800 How All That Holiday Eating Can Affect Your Sleep Tue, 21 Nov 2017 23:00:00 -0800 Sunrise, Sunset: Ancient Rhythms Still Dictate Human Life Category: Health News
Created: 11/21/2017 12:00:00 AM
Last Editorial Review: 11/22/2017 12:00:00 AM]]> Mon, 20 Nov 2017 09:00:00 -0800 Can you overdose on melatonin? Sun, 19 Nov 2017 23:00:00 -0800 Tonsillectomy and Adenoidectomy Surgical Instructions Category: Procedures and Tests
Created: 12/31/1997 12:00:00 AM
Last Editorial Review: 11/20/2017 12:00:00 AM]]> Fri, 17 Nov 2017 06:17:43 -0800 ResMed Elects Karen Drexler to its Board of Directors

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]]> Thu, 16 Nov 2017 20:00:00 -0800 Like a baby: The vicious cycle of childhood obesity and snoring

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]]> Thu, 16 Nov 2017 10:24:53 -0800 Alzheimer's found to be a side effect of obstructive sleep apnea, study finds Wed, 15 Nov 2017 20:00:00 -0800 Study shows therapy improves quality of life in people who have sleep apnea Wed, 15 Nov 2017 09:57:14 -0800 The Best Ways to Improve Your Sleep Beyond Reducing Your Coffee

It's more than likely that you’re not getting as much sleep as you should be. According to a 2011 survey by the Sleep Council, nearly half of us get six or less hours of sleep per night. Considering the recommended length of time to spend under the covers is seven to nine hours, six or less is extremely far from optimal.

“But it’s not my fault! I get into bed at the right time and my body just wants to stay awake.”

Health and Wellness: 
Latest News: 
]]> Tue, 14 Nov 2017 23:00:00 -0800 Health Tip: Stress Can Impact Sleep Category: Health News
Created: 11/15/2017 12:00:00 AM
Last Editorial Review: 11/15/2017 12:00:00 AM]]> Tue, 14 Nov 2017 09:48:22 -0800 Apple Watch can detect sleep apnea and high blood pressure Tue, 14 Nov 2017 06:15:28 -0800 With Cardiogram's AI, Apple Watch can detect sleep apnea, hypertension, study shows Mon, 13 Nov 2017 04:18:22 -0800 Correlates to problem behaviors in pediatric narcolepsy: a pilot study - Shelton AR, Malow B.

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]]> Fri, 10 Nov 2017 06:15:15 -0800 Sleep Apnea May Boost Alzheimer's Risk Fri, 10 Nov 2017 00:00:00 -0800 Obstructive sleep apnea linked to higher Alzheimer's risk Thu, 09 Nov 2017 23:00:00 -0800 Sleep Apnea May Boost Alzheimer's Risk Category: Health News
Created: 11/10/2017 12:00:00 AM
Last Editorial Review: 11/10/2017 12:00:00 AM]]> Thu, 09 Nov 2017 09:57:25 -0800 5 Suggestions For People Who Sleep With A Snorer

You don't have to be a rocket scientist to help someone stop snoring. Here are 5 easy to follow DIY remedies for snoring partner.

How to Stop Someone from Snoring

Health and Wellness: 
Latest News: 
]]> Thu, 09 Nov 2017 07:00:00 -0800 Worrying about insomnia may do more harm than poor sleep Thu, 09 Nov 2017 02:00:00 -0800 Sleep apnea in children impairs memory consolidation Wed, 08 Nov 2017 23:00:00 -0800 Polycythemia (High Red Blood Cell Count) Category: Diseases and Conditions
Created: 8/14/2009 12:00:00 AM
Last Editorial Review: 11/9/2017 12:00:00 AM]]> Tue, 07 Nov 2017 23:00:00 -0800 Here's Why You 'Space Out' After Too Little Sleep Category: Health News
Created: 11/7/2017 12:00:00 AM
Last Editorial Review: 11/8/2017 12:00:00 AM]]> Mon, 06 Nov 2017 23:00:00 -0800 Health Tip: Travel With a Blanket Category: Health News
Created: 11/7/2017 12:00:00 AM
Last Editorial Review: 11/7/2017 12:00:00 AM]]> Mon, 06 Nov 2017 13:19:23 -0800 A vacuum cleaner up my nose banished my snoring Wed, 01 Nov 2017 00:00:00 -0700 Bad Hot Flashes, Sleep Apnea Often Go Together Category: Health News
Created: 11/1/2017 12:00:00 AM
Last Editorial Review: 11/1/2017 12:00:00 AM]]> Tue, 24 Oct 2017 00:27:07 -0700 The science of sleep: Finding a cure for narcolepsy Sat, 21 Oct 2017 23:00:45 -0700 Dreaming of a cure: the battle to beat narcolepsy Fri, 06 Oct 2017 03:33:13 -0700 Newly formed Montco biopharm firm raises $270M Thu, 05 Oct 2017 08:24:00 -0700 Melatonin Benefits, Risks: What You Need to Know Wed, 04 Oct 2017 13:15:13 -0700 Working Night Shifts May Widen Your Waistline Mon, 02 Oct 2017 11:24:28 -0700 Nobel Prize Winners Unlocked Your Sleep Secrets Sun, 01 Oct 2017 23:00:00 -0700 Narcolepsy (Definition, Symptoms, Treatment, Medication) Wed, 27 Sep 2017 10:19:54 -0700 If You Are Not Sleeping Well, Try One of these Vegan Sleep Aids

It is thought that more than a third of American adults are not getting enough sleep on a regular basis. Sometimes, a change in diet can be helpful.

The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults aged 18–60 years sleep at least 7 hours each night to promote

Health and Wellness: 
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]]> Tue, 26 Sep 2017 23:00:00 -0700 Snoring (Causes, Aids, Remedies, Solutions) Tue, 26 Sep 2017 07:15:13 -0700 Sleep Deprivation a Serious Threat: Expert Fri, 15 Sep 2017 13:48:38 -0700 Snoring can be stopped with five-minutes-a-day exercises Fri, 15 Sep 2017 08:41:56 -0700 Lab notes: from ancient zero to space hero – this week's science goes down in a blaze of glory Sun, 27 Aug 2017 04:31:55 -0700 Here’s Why Vegans May Sleep Better Than You Do

Do vegans sleep better? The answer may lie in some new research on diet and insomnia. Researchers have found that our diet directly affects how well we sleep. This may uncover why people who eat high carbohydrate diets, like vegans do, may sleep better. So, if sleep has been hard to come by, your diet choices are well worth taking a good honest look at.

Health and Wellness: 
Latest News: 
]]> Tue, 15 Aug 2017 07:11:46 -0700 Sleepless Tech Users Sacrifice Sleep Health
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]]> Thu, 10 Aug 2017 08:01:00 -0700 The End of Sleep Medicine - Part 3
To quote Whitney Houston: "I believe the children are our future."

The problem of sleep-disordered breathing is epidemic, like diabetes, heart disease, and obesity. I would argue and have elsewhere in this blog that all three of those conditions can be attributed to, at least in part, the chronic intermittent hypoxia that occurs when the person sleeping is not getting air into their lungs.

For the most frightening development (if you can call it that) is the increasing occurrence of the conditions listed above in children.

The prevalence of sleep-disordered breathing is 3 to 5 percent among all children - this is scary!

One of the many challenges for the field of sleep medicine seeking to address this problem in a cost effective manner.  Of course, in lab polysomnography or even a sleep study done at home would provide more data reducing the possibility of false positives or false negatives, but the number of children at risk is too great and the cost in either case is prohibitive.

A study published in the ATS Blue Journal provides evidence that use of oximetry aided by computer analysis alone was sufficient to screen children to determine who needed an intervention.

This could be at a significant savings (90 to 95%) over what the cost might otherwise be. As described in the study this machine learning enabled test can provide an inexpensive test to anyone who has access to a smart phone.

An increased awareness about the importance of sleep particularly among children coupled with the ability to screen for sleep-disordered breathing cost effectively should, I would say must, incorporate this into to all pediatric practice.

The field (calling all Clinical Sleep Health Educators) has its work cut out for it to disseminate the availability of this technology to help insure there will be children in our future.

Again to quote Whitney Houston:  "It is the greatest love of all."

]]> Tue, 01 Aug 2017 04:37:51 -0700 Helping Kids Sleep Well When Naps End
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]]> Tue, 01 Aug 2017 04:35:04 -0700 Keep Tots Away from Tech for Better Sleep
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]]> Tue, 01 Aug 2017 04:33:04 -0700 Why An All-Nighter Can Be Harmful To Your Health
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]]> Tue, 01 Aug 2017 04:26:45 -0700 The Best Places to Nap
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]]> Thu, 13 Jul 2017 09:43:58 -0700 Get the Benefits of Turmeric with this Delicious Turmeric Latte Recipe

You have likely heard the buzz about turmeric. This cousin of ginger, common in Indian cooking may be the most effective nutritional supplement you can add to your diet. Keep reading for my recipe for a delicious turmeric latte that you will want to drink every day.

Benefits of Turmeric

Latest News: 
]]> Sat, 11 Jun 2016 16:15:44 -0700 Implantable device cuts obstructive sleep apnea symptoms Fri, 22 Apr 2016 11:09:11 -0700 Sleep loss detrimental to blood vessels Wed, 09 Mar 2016 03:18:18 -0800 Trouble sleeping? The size of your tongue and tonsils could be why Wed, 14 Oct 2015 11:04:10 -0700 More than one-third of perimenopausal women develop insomnia Wed, 02 Sep 2015 09:30:26 -0700 New symptom may help ID sleep apnea in older women Mon, 23 Mar 2015 10:33:00 -0700 Atrial fibrillation, the LEGACY study, and obstructive sleep apnea
Medscape discusses the findings of the LEGACY trial here:  (for registered users of Medscape)

Here is a link to the article's abstract:

I wonder how much of the improvement in atrial fibrillation came from the treatment (by weight loss) of undiagnosed obstructive sleep apnea???

There is strong evidence for a relationship between OSA and atrial fibrillation.  Control of obstructive sleep apnea through CPAP treatment approximately doubles the success rate of rhythm control in persons with atrial fibrillation.]]> Tue, 14 Oct 2014 04:30:00 -0700 The End of Sleep Medicine (Part 2) "You can have any color you want, as long as it is black." - Henry Ford

My earlier posts paint an uncertain picture about the future of sleep medicine as it relates to the diagnosis and treatment of obstructive sleep apnea. That said, I see that there are a number of inescapable realities. I have listed them below and included my thoughts about them. How the sleep medicine community chooses to deal with these realities and possibly others will likely dictate the future of sleep medicine.

Reality #1 - Obstructive sleep apnea (OSA), a chronic condition, is far more prevalent than originally imagined and is likely to become even more common due to the rising incidence of obesity and aging of the population. To call it an epidemic is no longer hyperbole.

The number of people suffering with sleep apnea varies depending on who you ask. But whatever number you believe, it is a very large getting larger.  And if you include children the figure are staggering. Something needs to be done to address the 80% who remain undiagnosed and the 50% who are nonadherence due to ineffective treatment.

Reality #2 - The consequences of untreated OSA are more than just reduced quality of life and excessive daytime sleepiness. The effects of OSA impact most, if not all, organ systems in the body.

Current medical research is showing connections between sleep apnea and other diseases, such as some forms of Cancer, Alzheimer's and ADHD in children.  These comorbid conditions arise in part from the chronic intermittent hypoxia that occurs during the apneic events. The connection with hypertension and other cardiovascular disease is solid and that alone warrants finding ways to prevent sleep apnea if possible or to treat it effectively to mitigate further injury.

Reality #3 - There is more  technology available to diagnose and treat OSA and will continue to increase in variety/sophistication in the coming years, including at some point a pharmaceutical intervention.

Diagnostic technology for “out of center testing” continues to improve and while it is unlikely to ever replace in-lab polysomnography insurance companies are now requiring a home test first to determine a diagnosis of OSA. Positive Airway Pressure therapy machines look less and less like medical devices and wireless communication contained in them is facilitating greater ease in monitoring adherence to therapy. Oral Appliance Therapy for mild to moderate OSA has evolved as well making it an acceptable first line treatment. Greater precision  for surgical options is improving the rate of success. Other therapies are in development as well to address the broad range of disease that present.

Reality #4 - The number of Board Certified Sleep Medicine Physicians is not increasing at rate to keep pace with the increasing number of people who need care.

The problem of a narrowing pipeline of physicians is also a problem in other specialities as well, including primary care. The need for appropriately trained allied health professionals, such as those Credential in Clinical Sleep Health to work with primary care and with sleep medicine specialists is great. These physician extenders are the key to getting the undiagnosed into treatment, and to insuring they are adherent. Dentists also have a role to play in screening patients for OSA and with appropriate training treating that portion that will respond to OAT.

Reality #5 - Deductibles and co-pays for health insurance coverage will be set at such a point now that many of the expenses associated with diagnosing and treating OSA will be out-of-pocket or using a health savings account.

There are a number of changes in how healthcare is delivered in the United States, among them is the financial participation required by the consumer. Affordability of diagnosis and treatment will play a role how, particularly those in safety sensitive positions like transportation, chose to proceed.

The future holds great possibilities for the field of sleep medicine, but success is contingent on a willingness to adjust to a changing landscape and to accept that there is plenty of work to go around. It is fair to say that the last sleep apnea patient is not walking through the door and that black is not the only color available.
]]> Fri, 03 Oct 2014 04:44:00 -0700 The End of Sleep Medicine (part 1) "Rumors of my demise are greatly exaggerated" - Mark Twain
I believe the field of Sleep Medicine about to enter a golden age. There is a convergence of several occurrences that leads me to that.
First, people spend a lot time talking about their sleep, mostly how they don't get enough of it. The technology (i.e. smartphones) has now advanced to point it can provide the tools for people to not only measure, relatively accurately, how much sleep they are getting but help improve the quality of their sleep.
Witness the success of the Kickstarter campaign that raised $1,000,000 in four days for the "Sense" device ( A device that takes all those sleep apps for the smartphone one-step better. Even the Positive Airway Pressure device manufacturer ResMed is getting involved with their introduction of the S+ device to monitor and improve sleep ( independent of treating sleep-disordered breathing.
Further evidence that many people are actively using sleep monitoring technology comes from Jawbone. Two recent news releases from them provides, what I believe to be the first publication using "big data" on sleep. The Jawbone Blog published the results of an analysis of sleeping patterns ten of thousands of Jawbone wearers - worldwide. ( They were able to discern which city's the most sleep, the least sleep and other characteristics. The second blog post from 
Jawbone was published after the earthquake in Napa California. ( The graph shows the disruption in sleep depending on how close they were to Napa.
The second occurrence that leads me to believe that we are entering the golden age of sleep medicine is the amount published research in the field. A recent search of the National Library of Medicine ( on the terms "sleep disorders" and research resulted more than 9600 entries, with the earliest being 1963. The pace of published research is accelerating with a doubling of the number of published items in just the last 10 years.
People everywhere are interested in sleep, improving it as much as possible through appropriate monitoring technology. The amount of research related to sleep is increasing at an exponential rate. 

Far from the demise, those involved in Sleep Medicine have much to do in terms of helping the public better understand the data from their smartphones and to build on the research currently underway to comprehend the mysterious, little understood third of our lives.

The future is rich with possibilities.

Finally, improving sleep by diagnosing and effectively treating what may well the most common chronic sleep disorder, sleep apnea, has reached out beyond a limited number of specialists, primarily pulmonologists to other medical professionals (primary care physicians, cardiologists and dentists). The number of diagnostic modalities has increased as have the number of treatment options. 
It is this change, that I will discuss in part two of the end of sleep medicine.

]]> Sun, 30 Mar 2014 10:31:17 -0700 Baby Monitors in Samsung Galaxy S5s? a

]]> Fri, 28 Mar 2014 08:53:59 -0700 Get Rid of Headaches for Better Sleep a

]]> Wed, 26 Mar 2014 08:01:44 -0700 Star Trek TOS Pillows a

]]> Mon, 24 Mar 2014 08:28:16 -0700 Firefighter Bed Sheets a

]]> Sun, 23 Mar 2014 13:32:42 -0700 Doctor Who and The Companion Pillow Cases a

]]> Sun, 16 Mar 2014 17:06:00 -0700 The ASAA first PSA posted to YouTube seven years ago... a classic, Thanks NIH! Sat, 15 Mar 2014 16:38:00 -0700 Must-have-titles for your Sleep Bookshelf...
 Dr. Dement's 1991 book set the stage for the discussion about the importance of sleep to health. Our hope is that he will have an opportunity to provided an updated version.

Written in 1993 Professor Stradling's book is still an authoritative text on the subject of sleep apnea - diagnosis and treatment. 

Dr. Lavie's book is a fascinating history of the study of breathing with some unlikely characters along the way.

Dr. Park, an ENT surgeon has an interesting take on how to address issues of sleep and sleep- disordered breathing.

There are so many other volumes on the subject worth reading and having as part of your sleep library.

Sleep well.

]]> Wed, 01 Jan 2014 01:27:34 -0800 Sing without breathing : Amazing A Capella singers - Cruella DeVille - Vocal Spectrum apneaa_capellabreathinsanequatuorsingsingerSing without breathing : Amazing A Capella singers - Cruella DeVille - Vocal Spectrum
mistersexybuzz]]> Fri, 18 Oct 2013 20:07:58 -0700 New Apnea World Record in a frozen lake - Greenland! New Apnea World Record in a frozen lake - Greenland!
mistersexybuzz]]> Mon, 12 Aug 2013 16:30:24 -0700 3 Weird Things People Do in Their Sleep apneabehaviorbizarreEducationKnowledgepeoplesleep3 Weird Things People Do in Their Sleep
Geo Beats]]> Wed, 31 Jul 2013 17:22:18 -0700 Tv9 Gujarat - Robotic surgery to cure apnea beamed live to doctors worldwide ,Mumbai 2toapneaapnea.tobeamedcurelivelivebeamedTv9 Gujarat - Robotic surgery to cure apnea beamed live to doctors worldwide ,Mumbai
TV9 Gujarat]]> Fri, 08 Mar 2013 21:49:00 -0800 Sleep-disordered breathing symptoms among African-Americans in the Jackson Heart Study.]]> Sun, 16 Dec 2012 18:51:00 -0800 Link Between Sleep Disturbance and Suicide Here is a link to the actual journal article being discussed:
There has been a lot of research looking at the relationship between insomnia and depression.  Insomnia does appear to be a risk factor for depression, but it is difficult in these population-based studies to definitively demonstrate a causal relationship.  The fact that insomnia is one of the symptoms of depression makes it especially difficult.  The article being discussed looks specifically at suicide.
Michael Rack, MD

Lack of good, solid sleep on a regular basis has been recognized by doctors as a risk factor for increased health problems for many years. For example, presence of untreated obstructive sleep apnea (OSA) greatly raises the risk of cardiovascular disease, stroke and premature death. More recent studies have established a link between insomnia and increased risk of suicide. This isn’t completely surprising, given that almost everyone has experienced a sour mood after a poor night of sleep. One can begin to imagine how it would feel for this to go on and on for months or even years.

The question of sleep quality and suicide is a difficult one to approach, and not just because of the emotional nature of the topic. Many studies have found such an association, but they were unclear about cause and effect, especially as depression and/or anxiety were also often involved. It has therefore been uncertain if poor sleep and suicide were, for example, two separate effects of depression or anxiety, versus there being a direct link between lack of sleep and taking one’s life. After all, depression and anxiety are risk factors for both poor sleep and suicidal thoughts and actions.

The newest study does a better job of teasing out the separate variables involved in sleep quality and suicide. The results suggest that even when depression and anxiety are factored into the analysis, people who slept poorly were still more likely to think about, plan, or actually make attempts at suicide. This was possible because tens of thousands of people were considered in the study, and this included many depressed or anxious people who were not bothered by poor sleep. Depressed and anxious people who managed to sleep fairly well were much less likely to commit suicide than similar folks who reported poor sleep.

The study was conducted in Norway, where extremely detailed records are kept of peoples’ health histories as well as all causes of death. Another aspect of the study that gives it significance is that there was a “dose-response” relationship – a term borrowed from tests of medications – between worse sleep and greater likelihood of suicidal thoughts, plans or actions. People who indicated they had poor sleep ‘almost every night’ had significantly more suicidal thoughts and actions than those who said their sleep was poor ‘two or three nights a week’ or ‘once a week of less.’

This most recent study comes on top of many others in the past decade or more that hinted at the same conclusion. While some of those studies were small or had other weaknesses to them, the Norwegian study corrected for virtually all such faults. The study was published in the peer-reviewed medical journal Sleep. It was accompanied by an editorial by Dr. W. Vaughn McCall, a sleep expert at Wake Forest University Health Sciences Center in Winston-Salem, NC. He noted that the cumulative studies on this topic had been done with many different populations of people, both old and young, and concluded bluntly, “The time has come to recognize insomnia as a risk factor for suicide, and to include it in the list of potentially modifiable risk factors.”

This study and the ones preceding it have practical ramifications. Dr. McCall urged doctors to ask more exploratory questions of those patients seeking sleep aids, to determine if there are signs of depression or actual thoughts of suicide that deserve treatment along with the insomnia complaint. As for the average person, those suffering from insomnia should make all reasonable attempts to sleep better, whether by getting more exercise during the day or by visiting their doctors to discuss their sleep problems.

Sometimes getting a better night’s sleep involves only simple behavioral changes, such as not exercising or watching TV right before bedtime. In other cases, a short-term course of medication, perhaps with some counseling sessions, may be in order. The outcome of such interventions may go well beyond simply giving someone a better night’s sleep, to actually having a life-saving effect.

SleepDisorders.comis an informational portal helping to educate sleep disorder sufferers and connect them to doctors in their area.
]]> Tue, 23 Oct 2012 16:16:00 -0700 Sleep Apnea – NOT for Men Only! )

Michael Rack, MD
Doctors and patients alike are beginning to realize that sleep apnea in women is more common than previously thought. Men remain statistically more likely to develop obstructive sleep apnea (OSA), but instead of a ten-to-one ratio of men to women, it’s now thought to be three- or four-to-one. At the same time, women also remain more likely to have sleep apnea misdiagnosed as something else, such as chronic fatigue syndrome, depression or simple insomnia. 

OSA occurs when the soft tissues of the throat and at the back of the mouth become overly relaxed at night, to the point where one’s airflow is blocked upon breathing in. This results in a few seconds of not breathing, which may be evidenced by snoring or gasping for breath during one’s sleep, followed by daytime sleepiness. Though women with OSA may have these signs, they seem to appear more often in men. Women with sleep apnea may notice their mouths being very dry in the morning. They may also begin to wake up more often during the night with the need to urinate. This is notdue to any real increase in urine production, but because the partial waking that often occurs in OSA allows a person to notice the state of their bladder more than when they are sleeping soundly.

The risk for OSA increases as a woman ages and it is sometimes said that menopause increases the risk for it. However, here again, appearances may be deceiving, with menopause getting the blame for simple changes in soft tissue tone that come with aging. Another risk factor for OSA in women, just as in men, is being overweight or obese. This is simply due to the increased thickness of throat tissues that begin to accumulate fat cells. In some studies, as many as 80% of obese women screened for sleep apnea were found to have the condition. It can also flare up due to the weight gain of pregnancy. Drinking alcohol before bed time also increases the likelihood of OSA, as does smoking.

Though women are still a bit less likely than men to have OSA, it unfortunately appears that their risk of mortality from it is greater than in men. The reason for this is not clear, but it seems to be especially true in regards to heart and circulation problems, i.e., decreased cardiovascular health. It was recently reported that OSA increases the risk of developing so-called ‘soft’ plaques in atherosclerosis (hardening of the arteries), which are more likely to come loose from blood vessel walls and form an embolus, blockage of an artery or vein.

If a woman has sleep apnea, especially if she is overweight or obese, she has a greater risk during pregnancy of developing the life-threatening condition called pre-eclampsia, or of needing to deliver her baby by caesarian section. Since pregnancy itself somewhat raises the risk of OSA, this seems a real life case of double jeopardy! A pregnant woman may also be more apt to attribute daytime sleepiness or fatigue to simply carrying a baby, rather than to other possible causes.  

For all these reasons, it is especially important for women to know that they, too, are at risk for sleep apnea. If there are signs of dry mouth, excessive daytime sleepiness, or any reports from her partner that she is snoring, a woman should not hesitate to ask her doctor if she might have sleep apnea. It is diagnosed definitively by performing an overnight sleep study at the hospital. Because OSA can have serious health repercussions if left untreated, insurance companies typically cover both the sleep study and the therapy the condition requires if found. Women and men alike thus have nothing to lose with a sleep study, and may also gain a much better night’s sleep for their efforts.

Guest article by Alex Smith of
]]> Tue, 02 Oct 2012 09:03:00 -0700 Oral Appliances or CPAP, Which is Better?
Devices that provide CPAP, or continuous positive airway pressure, are often considered the “gold standard” of treatment for obstructive sleep apnea. After a sleep study is conducted and sleep apnea is diagnosed, a sleep specialist will typically prescribe CPAP machines and masks as the first line of treatment. Though the sleep disorder solution may be a blessing to many, others may find the device loud, restrictive and ineffective in getting them a better night’s rest. For patients who do not tolerate CPAP therapy, the American Academy of Sleep Medicine (AASM) has offered its recommendation for alternatives in the form of oral appliances.

In an issue of Sleep, researchers at the AASM released updated instructions for the treatment of obstructive sleep apnea with CPAP alternatives in an article entitled, “Practice Parameters for the Treatment of Snoring and Obstructive Sleep Apnea with Oral Appliances.” Since the publication of these guidelines in 2006, patients diagnosed with mild to moderate sleep apnea have been able to take advantage of alternative devices. Physicians will prescribe the oral appliances to those who have already responded poorly to CPAP or to those who simply prefer another method. However, the AASM still advocates CPAP as the best form of treatment for patients with severe sleep apnea.

According to the AASM’s guidelines, the first step to treating sleep apnea of any severity is to have the sleep disorder diagnosed by a physician with ample experience in Sleep Medicine, particularly with sleep-disordered breathing. You can find certified sleep professionals in your area by searching local or online listings for sleep centers. To find a sleep dentist trained in oral appliances, experts such as Ira Shapira, DDS recommend that you find a sleep specialist that is a Diplomate of the Academy of Dental Sleep Medicine (ADSM).

If you have ever had to wear a mouth guard or an orthodontic retainer at night, you won’t have too much trouble adapting to an oral appliance for sleep apnea. The devices are designed to prevent the airway from collapsing while you sleep. This is most often achieved by moving your lower jaw, jaw muscles, uvula, soft palate, tongue or a combination of several of these parts.

The most common type of oral appliance is a mandibular repositioning device, which uses the upper jaw as an anchor to bring the lower jaw forward. In this position the walls of the pharynx and the tongue are also corrected. There are other oral appliances for sleep apnea available too, such as the tongue retaining device, which uses a suction mechanism to keep the tongue from falling backward and blocking the throat while you lie down.

In general, oral appliances have a higher compliance rate than CPAP in treating obstructive sleep apnea. Less than half of patients that are put on a CPAP treatment plan are actually able to continue the use of their machines and masks as recommended. And even these patients sometimes prefer oral appliances over CPAP because the oral devices are supposedly easier to use during travel and feel less distracting in shared bedrooms. Some oral devices, such as the Thornton Adjustable Positioner (TAP), have volume knobs that allow the patient to be more in control of sleep apnea treatment. Others, such as the Somnomed appliance, feature a straw through which you can drink water at night. In the end, the specific brand of oral appliance you use is not as important as keeping the upper airway unobstructed.

This is a guest blog post: is designed to link sleep disorder sufferers to local sleep doctors and sleep centers. In addition to our directory of sleep doctors, you can find informational articles related to your unique sleep disorder.


My thoughts:  Oral appliances are a reasonable treatment option for mild to moderate OSA.  CPAP remains the gold standard, especially  for more severe forms of OSA.   Oral appliances can be difficult to tolerate for some patients.  In order to have success with an oral appliance, the involvement of a well-trained dental sleep specialist, working with a board-certified sleep doctor, is necessary.  I do NOT recommend mail-order dental appliances.

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